Goat-milk-based infant formulas (GMFs) are now available in several countries, having been approved by authorities. We systematically evaluated the effects of GMF compared with cow-milk-based formula (CMF) on infant growth and safety parameters. The MEDLINE, EMBASE, and Cochrane Library databases were searched (December 2022) for randomized controlled trials (RCTs). The risk of bias was assessed using the Revised Cochrane Risk-of-Bias tool (ROB-2). Heterogeneity was quantified by I2. Four RCTs involving a total of 670 infants were identified. All trials revealed some concern in ROB-2. Furthermore, all of the included studies were funded by the industry. Compared with infants fed CMF, those fed GMF showed similar growth in sex- and age-adjusted z-scores for weight (mean difference, MD, 0.21 [95% confidence interval, CI, −0.16 to 0.58], I2 = 56%), length (MD 0.02, [95% CI −0.29 to 0.33], I2 = 24%), and head circumference (MD 0.12, 95% [CI −0.19 to 0.43], I2 = 2%). Stool frequency was similar among the groups. Due to differences in the reporting of stool consistency, no firm conclusion can be drawn. Adverse effects (serious or any) were similar in both groups. These findings provide reassurance that GMFs compared with CMFs are safe and well tolerated.
Objective:The dogma of probiotic strain-specificity is widely accepted. However, only the genus-and species-specific effects of probiotics are supported by evidence from clinical trials. The aim of this rapid review was to assess clinical evidence supporting the claim that the efficacy of probiotics in the pediatric population is strain-specific. Methods: The Cochrane Library, MEDLINE, and EMBASE databases were searched (up to August 2022) for randomized controlled trials (RCTs) conducted in children aged 0-18 years evaluating the effects of prophylactic or therapeutic administration of probiotics (well-characterized at the strain level) for conditions such as antibiotic-associated diarrhea, acute diarrhea, necrotizing enterocolitis, respiratory tract infections, Helicobacter pylori infection, and atopic dermatitis. To allow evaluation of strain-specificity, a trial could only be included in the review if at least one additional RCT assessed the effect of a different strain of the same species against the same comparator. RCTs without proper strain-level data were excluded. In the absence of identifying head-to-head strain versus strain RCTs, indirect comparisons were made between interventions. Results: Twenty-three RCTs were eligible for inclusion. Out of the 11 performed comparisons, with 1 exception (two Lacticaseibacillus paracasei strains in reducing atopic dermatitis symptoms), no significant differences between the clinical effects of different strains of the same probiotic species were found. Conclusions: Head-to-head comparison is an optimal study design to compare probiotic strains, but such comparisons are lacking. Based on indirect comparisons, this rapid review demonstrates insufficient clinical evidence to support or refute the claim that probiotic effects in children are strainspecific.
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